Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective.
Denise Sullivan, Mary Lyons, Robert Montgomery and 1 others
PMID 27828892WHAT IT FOUND
Trauma pain care can use opioid-sparing options and the right pain scale; nurses and physical therapists need to watch for safety and use distraction as an adjunct, not a replacement.
Key findings
01The review recommends matching pain scales to age and cognitive status, and using behavioral tools with practitioner observation when patients cannot self-report.
02Acetaminophen and NSAIDs are supported as opioid-sparing first-line options, but liver injury, gastrointestinal bleeding, kidney problems, and bone-healing concerns require caution.
03Non-drug methods such as distraction during physical therapy for children and adolescents with burns may complement analgesics, but the supporting studies were not double-blind.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
It is a review, not a controlled trial of a whole treatment plan, so it cannot show which option is best for a particular trauma patient. The search was limited to recent articles, with some older citations added by author judgment, and the review is not exhaustive. Some recommendations are expert opinion, not cited evidence. Nonpharmacologic studies were not double-blind. Some evidence comes from postsurgical settings, not only trauma. Several interventions require trained providers, monitoring, or special resources. Off-label uses are discussed for several drugs.
The easy way to misread this
Do not read this review as proof that any opioid-sparing plan works better than opioids for every trauma patient. It summarizes many different studies and expert recommendations, and nonpharmacologic options are described as complementary, not substitutes.